A non-contagious, fungal form of meningitis has sickened 26 people in five states, killing four. The deadly disease has been linked to tainted steroid injections.

Those sickened had received steroid injections to the spine. WebMD says the meningitis has been traced to steroid injections (methylprednisolone acetate) made by a single compounding pharmacy: The New England Compounding Center (NECC), located in Framingham, Massachusetts. The NECC recalled three suspect lots of the medication; clinics that ordered the injections were notified, but that action was not made known to the public.

The Tennessee victims range in age from 49 to 89, state Health Commissioner Dr. John Dreyzehner told CNN; 11 patients have been hospitalized. “The prime suspect for this outbreak is methylprednisolone acetate,” Dreyzehner added.

Per the request of state health officials, the NECC has agreed to voluntarily surrender its license to operate until the investigation is completed, according to Boston.com.